Individual
MRS. LAURA JEAN STAVRAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
399 EMILY DR, CLARKSBURG, WV 26301-5505
(304) 624-4315
(304) 624-4319
Mailing address
125 N 6TH ST, CLARKSBURG, WV 26301-2665
(304) 624-7200
(304) 624-4319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01156
WV
Other
Enumeration date
01/13/2006
Last updated
01/23/2015
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